Supplementary Materials to “Microwave ablation of hepatocellular carcinoma as first-line treatment: long term results and prognostic factors in 221 patients ”
Tao Wang1*, Xiao-Yu Zhang3*, Jia-Chang Chi1, Min Ding1, Li Zhang4, Xiao-Jie Lu2, Bo Zhai1
1.Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
2.Department of Gastroenterology, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
3.Department of General Surgery, the Affiliated Huai’an Hospital of Xuzhou Medical College and Huai’an Second People’s Hospital, Huai'an, China.
4.Department of Statistics, School of Life Sciences, East China Normal University, Shanghai, China.
Table S1. Technical parameters of MWA in 211 patients
Ablation timeper tumor / Range / 4-34 min
Mean ± standard deviation / 12.2 ± 6.1 min
Ablation
strategy / Single ablation / n=118
Multiple overlapping ablation with single electrode / n=127
Multiple overlapping ablation with multi-electrode and multiplanar ablation strategy / n=69
Total number of HCC lesions / n=314
Use of artificial ascites / n=3
Use of artificial pleural effusion / n=3
MWA: microwave ablation; HCC: hepatocellular carcinoma
Table S2. Univariate analyses of prognosticators of recurrence-free survival and overall survival.
Clinicopathologic features / p valueRecurrence-free survival / Overall survival
Age, years, (<60 vs >=60) / 0.406 / 0.319
Gender (male vs female) / 0.577 / 0.496
Etiology (HBV vs HCV vs others) / 0.667 / 0.721
Child score (A vs B) / 0.874 / 0.403
Cirrhosis (absent vs present) / 0.746 / 0.756
Tumor number (1 vs 2 vs 3) / 0.063 / 0.059
Tumor size, cm, (≤3 vs 3-5 vs >5) / 0.540 / 0.003
Tumor location (non-risk vs risk areas*) / 0.560 / 0.666
AFP, ng/ml, (≤20 vs 20-400 vs >400) / 0.004 / 0.005
PT, sec, (≤14 vs >14) / 0.995 / 0.700
INR, median (<1.3 vs ≥1.3) / 0.301 / 0.384
Platelets count, 109/L, (>100 vs ≤100) / 0.739 / 0.283
Albumin, g/L, (>35 vs ≤35) / 0.946 / 0.949
ALT, U/L, (≤40 vs >40) / 0.122 / 0.247
AST, U/L, (≤40 vs >40) / 0.309 / 0.219
ALK, U/L, (≤110 vs >110) / 0.089 / 0.075
GGT, U/L, (≤50 vs >50) / 0.026 / 0.031
Tbil, μmol/L, (≤25 vs >25) / 0.803 / 0.214
Creatine, μmol/L, (≤110 vs >110) / 0.428 / 0.397
Technique effectiveness (CA1st vs CA2nd) / 0.608
Technique effectiveness (CA1st vs CA 2nd vs IA) / NA / <0.001
Types of recurrence (LTP vs IDR vs ER) / NA / <0.001
HBV: hepatitis B virus; HCV: hepatitis C virus; INR: international normalized ratio; AFP: alpha fetal protein; ALT: alanine transaminase; AST: aspartate transaminase; GGT: gamma-glutamyl transpeptidase; PT: prothrombin time; ALK: alkaline phosphatase; TBil: total bilirubin; CLIP: Cancer of the Liver Italian Program; BCLC: Barcelona Clinic Liver Cancer; CA1st: complete ablation at first microwave ablation (MWA); CA2nd: incomplete ablation at first MWA but complete ablation at second MWA; IA: remaining incomplete ablation after two sessions of MWA; LTR: local tumor recurrence; IDR: interhepatic distant recurrence; ER: extrahepatic recurrence. *: Tumors in risk areas refer to those located within 5 mm of diaphragmatic dome, big vessels or cavity viscera, excluding those protruding from liver surface, contacting or adhering to diaphragm, or abdominal viscera.
Table S3. Correlations between tumor characteristics and complication rates
Complications / p valueYes / No
Tumor size, cm / ≤3 / 9(11.5%) / 69 / 0.716
3-5 / 9(10.2%) / 79
>5 / 4(7.3%) / 51
Tumor number / 1 / 12(8.0%) / 138 / 0.224
2 / 8(16.3%) / 41
3 / 2(9.1%) / 20
Tumor location / non-risk / 16(12.4%) / 113 / 0.15
risk areas* / 6(6.5%) / 86
*: Tumors in risk areas refer to those located within 5 mm of diaphragmatic dome, big vessels or cavity viscera, excluding those protruding from liver surface, contacting or adhering to diaphragm or abdominal viscera.
Figure S1. Treatment strategies after recurrence in patients with primary or secondary technique effectiveness.